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Association between childhood strabismus and refractive error in Chinese preschool children
Hui Zhu1, Jia-Jia Yu2, Rong-Bin Yu3
1First Clinical Medical College of Nanjing Medical University, Jiangsu Province, China.
Insights
Refractive errors like hyperopia and myopia are strongly linked to childhood eye conditions such as esotropia and exotropia. Early detection and management of refractive errors are crucial for preventing these strabismus types in young children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Childhood strabismus, including concomitant esotropia and exotropia, significantly impacts visual development.
- Understanding the relationship between refractive error and strabismus is vital for early intervention strategies.
Purpose of the Study:
- To investigate the association between concomitant esotropia or concomitant exotropia and refractive error in preschool children.
- To quantify the risk of developing these conditions based on specific refractive error types and severities.
Main Methods:
- A population-based study involving 5831 preschool children (aged 3-6 years) in Nanjing, China.
- Comprehensive eye examinations were conducted by trained professionals.
- Multivariate logistic regression analysis was used to determine associations and calculate odds ratios (ORs).
Main Results:
- Concomitant esotropia showed independent associations with anisometropia (ORs 3.15-7.41) and hyperopia (ORs increasing with severity, up to 180.82).
- Concomitant exotropia was associated with astigmatism (ORs 1.9-3.56), myopia (ORs 18.93-40.54), and hyperopia (ORs 8.36-67.78).
- A clear severity-dependent association was observed for hyperopia with both esotropia and exotropia.
Conclusions:
- Significant associations exist between various refractive errors (anisometropia, hyperopia, astigmatism, myopia) and the prevalence of concomitant esotropia and exotropia in preschool children.
- These findings underscore the importance of considering refractive error management in the context of childhood strabismus.
- Early screening and correction of refractive errors may play a role in preventing or managing these common childhood eye conditions.
Purpose:
To investigate the association between concomitant esotropia or concomitant exotropia and refractive error in preschool children.
Methods:
A population-based sample of 5831 children aged 3 to 6 years was selected from all kindergartens in a representative county (Yuhuatai District, Nanjing, Jiangsu Province) of Nanjing, China. Clinical examinations including ocular alignment, ocular motility, visual acuity, optometry, stereopsis screening, slit lamp examination and fundus examination were performed by trained ophthalmologists and optometrists. Odd ratios (OR) and 95% confidence intervals (95% CI) were calculated to evaluate the association of refractive error with concomitant esotropia and concomitant exotropia.
Results:
In multivariate logistic regression analysis, concomitant esotropia was associated independently with spherical equivalent anisometropia (OR, 3.15 for 0.50 to <1.00 diopter (D) of anisometropia, and 7.41 for > = 1.00 D of anisometropia) and hyperopia. There was a severity-dependent association of hyperopia with the development of concomitant esotropia, with ORs increasing from 9.3 for 2.00 to <3.00 D of hyperopia, to 180.82 for > = 5.00 D of hyperopia. Concomitant exotropia was associated with astigmatism (OR, 3.56 for 0.50 to 1.00 D of astigmatism, and 1.9 for <0.00 D of astigmatism), myopia (OR, 40.54 for -1.00 to <0.00 D of myopia, and 18.93 for <-1.00 D of myopia), and hyperopia (OR, 67.78 for 1.00 to <2.00 D of hyperopia, 23.13 for 2.00 to <3.00 D of hyperopia, 25.57 for 3.00 to <4.00 D of hyperopia, and 8.36 for 4.00 to <5.00 D of hyperopia).
Conclusions:
This study highlights the close associations between refractive error and the prevalence of concomitant esotropia and concomitant exotropia, which should be considered when managing childhood refractive error.
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